Local Advocacy Mini-Grant Application Complete and submit the application below by March 12th. Please send questions to caitlin@namica.org. OK Question Title * 1. Please provide contact information. Affiliate Name: Affiliate Mailing Address: Point of Contact: Point of Contact Phone: Point of Contact Email: OK Question Title * 2. Is your affiliate able to create a local advocacy calendar? Please describe the resources you have to undertake this task. OK Question Title * 3. Is your affiliate able to facilitate engagement between family members and local decision makers? Please list the decision makers you plan to reach out to as well as the number of family members who may be interested in participating. OK Question Title * 4. Is your affiliate able to plan and host local advocacy activities? Please describe the resources you have to undertake this task. Please describe what one of these activities might look like. OK Question Title * 5. Is your affiliate able to plan and host community collaboration meetings? Please describe the resources you have to undertake this task. Please list the organizations and individuals you would engage in these meetings. OK Question Title * 6. Is your affiliate able to create a local service guide? Please describe the resources you have to undertake this task. OK Question Title * 7. Is your affiliate able to host or participate in community outreach events? Please list the resources you have to undertake this task OR the partner organizations and events with whom and in which you will participate. OK Question Title * 8. Please select which funding level in which your affiliate is interested in participating (select all that apply). Level 1: $125 Level 2: $325 Level 3: $600 OK DONE